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CAM I > Infectious Disease > Flashcards

Infectious Disease Flashcards

1
Q

Gram positive bacteria

A 
Streptococcus (Group A, B, C, D, F, G)
Staph aureus (MSSA and MRSA)
Listeria
Bacillus
Pneumococcus
Tuberculosis and nocardia
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2
Q 
Gram positive (anaerobes)
Gut and skin and soft tissue
A

Peptococcus

Peptostreptococcus

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3
Q

Gram negative (enteric)

A

E. coli
Klebsiella
Proteus
Pseudomonas aeruginosa

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4
Q

Gram negative (respiratory)

A

Hemophilus spp.

Neisseria

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5
Q 
Gram negative (anaerobes)
GI tracts and environmental infections
A

Anaerobic Gram negative rods (Bacteroides fragilis)

Anaerobic Gram positive rods (Clostridium spp.)

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6
Q

Spirochetes

A

Syphilis

Borelia spp. (Lyme disease and others)

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7
Q

What to consider when thinking about medications

A

Always ask the question, “What am I trying to treat?”
FQs (Levo, Cipro, Moxi) esp if given with steroids have a black box warning for tendon rupture
Bactrim (TMP-SMX) is a great drug for staph, strep coverage is poor
Keflex is good for non-specific skin infections when MRSA is NOT suspected
For facial swelling, think clindamycin

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8
Q

Lab for Candidiasis

A

KOH prep

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9
Q

Tx for oral candidiasis

A

Clotrimazole troches, nystatin swish and spit. HIV usually need oral and/or prophylaxis

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10
Q

Tx for vulvovaginitis candidiasis

A

Uncomplicated may be treated with single Diflucan (fluconazole), 3-5 days of tx with terconazole, miconazole
Pregnant must use topical azole

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11
Q

Tx for cutaneous candidiasis

A

Topical nystatin or iconazole creme

Topical nystatin creme AND nystatin powder

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12
Q

What is found mostly in soil and pigeon droppings?

A

Cryptococcus neoformans

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13
Q

What is found in soil contaminated with bat or bird droppings?

A

Histoplasma capsulatum

Sx mimic influenza

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14
Q

Tx for Histoplasmosis

A

Itraconazole 200 mg/day divided in 3 doses for mild to moderate forms (sx < 1 mo). Oral solution is best

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15
Q

What type of population commonly has Pneumocystis jiroveci?

A

HIV pts, among others

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16
Q

Tx for Pneumocystis jiroveci?

A

TMP-SMX, steroids, Dapsone goold alternative tx
Alternative: Clinda + Primaquin
Pts often get worse at the start of tx
All pts with CD-4 count below 200 cells/microL need prophylactic, TMP-SMX drug of choice

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17
Q

Pneumocystis

A

Caused by a fungus commonly found in the lungs of people and many animals. Airborne, lies latent in alveoli.

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18
Q

Sx of pneumocystis

A

Fever
SOB
Non-productive cough

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19
Q

CXR of pneumocystis

A

Diffuse, patchy, miliary infiltrates. May develop spontaneous pneumothorax, fatigue, weakness, weight loss

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20
Q

Cause of acute rheumatic fever

A

Group A Beta-hemolytic strep pyogenes

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21
Q

Sx of acute rheumatic fever

A 
Fever
Sore throat
Body aches
Joint pain
Tachycardia
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22
Q

Chorea

A

Also known as Syndenham’s chorea, or St. Vitus dance. There are abrupt, purposeless movements. This may be the only manifestation of acute rheumatic fever and its presence is diagnostic. May also include emotional disturbances and inappropriate behavior.

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23
Q

Pathophysiology of botulism

A

Clostridium botulinum. Prevents the release of acetylcholine at neuromuscular junctions and autonomic synapses.

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24
Q

Pharmacological tx of botulism

A

Trivalent antitoxin

Potassium channel antagonists (Ibutilide, Dofetilide, sotalol) may provide symptomatic relief

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25
Q

Interventions for chlamydia

A

Doxycycline 100 mg BID x 7 days or
Azithromycin 1 gm PO x 1
Pregnancy: Azith or Amzx 500 mg PO BID x 7 days
Trachoma conjunctivitis: Azith 1 gm PO x 1
Alternate: Tetracycline 250 mg QID x 14 days

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26
Q

Hx and physical exam of cholera

A

Sudden severe frequent watery diarrhea liquid stool is gray, without odor, blood, or pus “rice water stool”

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27
Q

Interventions for cholera

A

Fluids! Fluids! Fluids!

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28
Q

Etiology of shigellosis

A

Gram negative facultative non-motile rod

Enterotoxin

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29
Q

Pharmacological tx for shigellosis

A

Cipro
Levo
Azithromycin

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30
Q

Hx and physical exam for diphtheria

A

Nasal infection produces few sx aothan than a nasal d/c. Laryngeal infection may lead to upper airway and bronchial obstruction. In pharyngeal diphtheria, the most common form, a tenacious gray membrane covers the tonsils and pharynx. Mild sore throat, fever, and malaise are followed by toxemia and prostration

31
Q

Pharmacological tx of diphtheria

A 
Antitoxin, which is prepared from horse serum, must be given in all cases when diphtheria is suspected.
PCN
Erytho
Azithro
Clarithro
32
Q

Etiology of gonococcal infections

A

N. gonorrhoeae, a gram-negative diplococcus

33
Q

Hx and physical exam of gonococcal infections

A

Urethritis and cervicitis
Disseminated disease- Purulent arthritis or the triad of rash, tenosynovitis, and arthralgias
Conjunctivitis

34
Q

Pharmacological tx of gonococcal infections

A

250 mg dose of intramuscular ceftriaxone in combination with a second drug (azithromycin or doxycycline)

35
Q

Pathophysiology of tetanus

A

Tetanospasmin acts at the spinal inhibitory neurons, where it plays a protein needed for release of neurotransmitters

36
Q

Hx and physical exam of tetanus

A

Stiffness of the jaw, neck stiffness, spasms of the jaw muscles (trismus) or facial muscles and rigidity and spasm of the muscles of the abdomen, neck, and back

37
Q

Pharmacological tx of tetanus

A

Tetanus immune globulin, 500 units IM within first 24 hrs of presentation
PCN, 20 million units IV daily in divided doses

38
Q

Prevention/maintenance for tetanus

A

Primary immunization of adults, Td as two doses 4-6 weeks apart, with a third dose 6-12 mos later. For one of the doses, Tdap (tetanus toxoid, reduced-dose diphtheria toxoid, acellular pertussis vaccine) should be substituted for Td

39
Q

Lab and diagnostic imaging for helminth/pinworm infestations

A

“Scotch tape” test (90% sensitivity when performed x3)

40
Q

Pharmacologic tx for helminth/pinworm infestations

A

Ivermectin

Mebendazole (pinworms)

41
Q

Etiology of malaria

A

Plasmodium vivax is about as common as P. falciparum

42
Q

Prevention/maintenance of malaria

A 
Prior to travel: Chloroquine
Doxycycline
Mefloquine
Primaquine
Hydroxychloroquine
Prevention of mosquito bites
DEET
43
Q

Central sx of malaria

A

HA

44
Q

Systemic sx of malaria

A

Fever

45
Q

Muscular sx of malaria

A

Fatigue

Pain

46
Q

Back sx of malaria

A

Pain

47
Q

Skin sx of malaria

A

Chills

Sweating

48
Q

Resp sx of malaria

A

Dry cough

49
Q

Spleen sx of malaria

A

Enlargement

50
Q

Stomach sx of malaria

A

N/V

51
Q

Hx and physical exam of malaria

A

Recent travel to endemic area. Classic paroxysm includes chills, high fever, and then sweats
Fevers become regular (with 48 hrs P. vivax and P. ovale or 72 hrs with P. malariae)

52
Q

Pathophysiology of salmonellosis

A

Fecal-oral route (eggs, undercooked chicken, dairy products)

53
Q

Interventions for salmonellosis

A

Fluids and electrolyte replacement mainstay of therapy

54
Q

Etiology of toxoplasmosis

A

Toxoplasma gondii is an obligate intracellular protozoan parasite

55
Q

Lab and diagnostic imaging for toxoplasmosis

A

ELISA most commonly used

56
Q

Pharmacological tx of toxoplalsmosis

A

Initial regimen of choice is pyrimethamine plus sulfadiazine, clindamycin for those allergic to sulfadiazine
Alternative: Pyrimethamine + atovaquone or azithromycin

57
Q

Hx and physical exam of Lyme disease

A

Regional adenopathy, low-grade intermittent fever, HA, myalgia, arthalgias, fatigue, malaise, classic “bulls-eye” rash (erythema migrans)

58
Q

Pharmacological tx of Lyme disease

A

Doxycycline 100 mg BID x 10 days, 2nd line amoxicillin. For cardiac, CNS, meningitis, see Sanford.
Amoxicillin recommended for treating pregnant pts

59
Q

Hx and physical exam of Rocky Mountain spotted fever

A

Most cases late spring and summer
American dog tick int he east
Rocky mountain wood tick in the west

60
Q

Etiology of syphilis

A

Treponema pallidum (spirochete)

61
Q

Hx and physical exam of syphilis

A

Primary: single chancre: indurated, firm PAINLESS with raised borders
Secondary: enters the bloodstream, generalized maculopapular rash, fever, diffuse adenopathy, thinning of lateral 1/3 of eyebrows

62
Q

Hx and physical exam of infectious mono

A 
Sore throat
Fever
Malaise
Tender splenomegaly
Tender posterior cervical lymphadenopathy
63
Q

Oncogenic types of HPV

A 
16
18
31
33
35
64
Q

Genital condyloma types of HPV

A

6

11

65
Q

Prevention/maintenance for HPV

A

Regular PAP smears

Quadrivalent HPV vaccine 9-26 yo

66
Q

Hx and physical exam of measles (rubeola)

A

Erythematous maculopapular rash
Begins at hairline, spreads to face, neck
Prodrome with fever, coryza, Koplik spots

67
Q

Hx and physical exam of rubella (German measles)

A

Pink, maculopapular rash, confluent on trunk, begins at the forehead, spreads to the trunk

68
Q

Etiology of rabies

A

Single-stranded RNA virus of rhabdovirus group

69
Q

Intervention for rabies

A

Quarantine asymptomatic animal for 10 days, sick animals MUST be tested by state health department
Clean and scrub wound thoroughly

70
Q

Pharmacological tx for rabies

A

If animal cannot be quarantined, begin vaccination and IG tx

71
Q

Rabies vaccination schedule

A

20 iu/kg as much as possible infiltrated in and around the wound. Balance IM into glute
Immunocompetent: 4 doses Human diploid cell vaccine, Day 0, 3, 7, 14

72
Q

Dog bites tx

A

Pasturella canis most common organism
Augmentin tx of choice
Alternative: Clinda + TMP-SMX (peds) OR clinda + cipro (adults)

73
Q

Cat bites tx

A

80% get infected < 24 hrs
Pasturella multocida most common organism
Culture
Agumentin tx of choice
Alternative: Cefuroxime axetile OR doxycycline
If cx is + for multocida, PenG or Pen VK

74
Q

Human bites tx

A

Multiple pathogens
Augmentin is tx of choice
Alternative: Clindamycin

CAM I (5 decks)

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